Provider Demographics
NPI:1164722070
Name:THE WOMEN'S BIRTH AND WELLNESS CENTER
Entity Type:Organization
Organization Name:THE WOMEN'S BIRTH AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLAUDINE
Authorized Official - Middle Name:P
Authorized Official - Last Name:CALLIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP, CNM
Authorized Official - Phone:480-833-6582
Mailing Address - Street 1:504 W UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85201-5627
Mailing Address - Country:US
Mailing Address - Phone:480-833-6582
Mailing Address - Fax:480-890-7467
Practice Address - Street 1:504 W UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-5627
Practice Address - Country:US
Practice Address - Phone:480-833-6582
Practice Address - Fax:480-890-7467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ13143261QB0400X
AZF0708635261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing